Oupatients!

(Monday) Nice early start at 6:30 ..... haha! On the way there it was really strange because you literally drive into mines! All you can see is fog & smoke, and the temperature dropped to -2.5!!!!!! It was crazy! The matron who picked me up said that when its really bad it can take up til 10 o clock to get into work! Craazzzyyyy!

After a tour around the hospital, I spent today in the outpatients clinic. It was really interesting to see a clinic that wasn't just HIV treatment, but more general treatment too! There is a lot of patients with hypertension and hyperglycaemia, and all the patients have medical aid from the company, or have their own medical aid. The hospital is so nice & posh as well .... its like the hospitals in the UK! Very modern and nice (: & everyone has been so nice & friendly!! Saw a wide mix of patients which was really good! The nurses get to do loads here, they take bloods and prescribe all the meds needed and make a diagnosis. Was great to spend some time with the nurses :D learnt a bit more about the training here too .... & its just so hugely different to the UK its weird! I guess its more like our older training for our general nurses! They get a bar for their epaulets with each part of the training they complete eg. one for mental health, one for midwifery etc! & they train at different levels (an assistant, a staff nurse or a sister). Tomorrow I am going to go to the mining clinic with the Dr (:

Witbank!

(Sunday) Got picked up this morning to go to Witbank! Was lovely and sunny on the journey was so hot in the car! Was so strange because everything is just so brown around you! Brown grass, brown trees .... thats winter for you! Was also very strange seeing sudden townships, mostly houses made of corrugated iron sheets. They seem to spring up from nowhere, and then suddenly it is all you can see. There is a lot of disused mine sites here, and the old ones were not properly excavated and looked after when they closed down! Am staying in a lovely Guest House that serves dinner too :D wooo! Looking forward to the hospital tomorrow! (: getting an early start though .... pick up at 6:30 am! :O

Chillax!

(Saturday) Spent the day chillaxxxiinnnggg to the max today! Was lovely :) got to spend some time filling in the family about what I had been up to all last week! Went for a walk for lunch & that was it :D haha! Am off tomorrow to Witbank in the morning getting driven there it takes about 2 hours! Looking forward to it! Getting to spend til Thursday in the coal miners hospital of Anglo American!! :D

Training & an almost real sized plane!

(Friday) Today was training for the staff, so I got the opportunity to compare theirs to ours! Was a good day & was cool to be part of it! Was thorough and all linked to things in the clinic. There was a talk about Wills, which was really interesting particularly as a lot of the patients don't have one when they die, or have not written them properly so they do not get counted! This makes things a lot more difficult. Another session was about TB and how it is spread and the best ways to be protected etc. Was really good & informative, especially as some of the background staff didn't really know the info, unlike the nurses & Drs who have had the training!! We also did a session on what OT is all about, which was brilliant fun. We got to play with playdoh and make things :D hehe! Was really good for the staff as most of them didn't know what OT was, or who to refer. The final session was an open forum for staff to discuss issues about the clinic, and have things explained to them. I thought this was a brilliant idea as it means they're all reading from the same page and ensures any mix-ups are cleared up! We then got a very nice chicken curry & the afternoon was going to be spent doing a mini sports day to end on something fun! All in all a very successful day :D


I then had my lovely flight home, on not such a small plane this time! On the way the plane was about 30 of us, 1 seat aisle then 2 seats (I got the billy 1 seat of course haha) & we didnt need steps we just walked up and in! One air hostess & job done!! Coming back it was 2 seats aisle 3 seats :O haha! Must be a busier time than 6:30am on a Monday :P surprisingly some of the business people I had flown with on Monday were on the same flight home, having probably spent the weekend working!


I have had such an amazing week I cannot begin to explain how life changing and eye opening it has been. This is why I wanted to come to Africa, to see the things I have seen this week & last week. One person may not be able to make a difference, but maybe one person can teach others what life is really like for these people, & then someday perhaps a difference will be made when people begin listening!!

Community Care & Birthday Cake!

(Thursday) Wow. How do I even begin to describe the things I have seen today? If you sit at home & think about what you think Africa is, what you will probably think is what I have seen today. Being out with the community team has been such an amazing privilege, a real eye-opener of how these people I have been seeing REALLY live.


The first lady we visited had a CD4 count of 1 (usual for us is around 500ish) when she started ARVs a few weeks ago. Yet today was her birthday, and she was doing incredibly well. The ladies I was out with said you would have never thought she was the same lady they had seen a few weeks ago, who could barely sit on her own. & there she was when we turned up dancing!! Amazing (: we had the honor of being able to sit down with the family after seeing how she was doing, and have birthday cake they had bought! It probably cost almost half of what she gets to feed her family, yet after we had sung some songs and said a prayer we all got to sit down and have some. About 12 of them live in the house, & as we ate all the chickens, dogs and new baby goats were running around us! Was great to see! Such a privilege and something I certainly won’t forget for a very long time to come!!


The next person we managed to find in was the man I had seen in the clinic the other day, who had lost all his skin and turned white. It was great to see him doing well at home, & his son was staying with him to help him out on a few things! The sense of community in the rural areas is really something (:


The last patients we saw were very cute! They were 2 little boys of 5 & 7. Their mother had died, and their father doesn’t want a lot to do with them so they stay with their grandmother. Despite being very old she looks after them very well. We asked the 7 year old about his ARVs and asked him to show how he takes them (this is to check his adherence and understanding!) & at 7 he could place out all the pills correctly, & say how often he took them! It was amazing. He reminds his grandmother of the time when he has to take them! It was amazing to see, & it really made it hit home what life is like for these children. They were lovely little boys, & when we left ran to the gate to wave to us as we drove off. So lovely to see 2 very happy little boys!

Colpo, Babies, IPU & RAIN!!!

(Wednesday) I spent the morning in the Colposcopy (Colpo) unit. This was really fascinating, but not for the faint hearted! Skip ahead if you’re squeamish!! Haha. The unit takes referrals from abnormal PAP smears, even from different clinics as the hospital waiting list is long and they perform the procedure under general anesthetic making it a much riskier procedure. Basically the procedure is to remove any abnormalities from the cervix. It’s amazing to see it done, and it is usually highly successful at reducing these ladies chances of developing cervical cancer (also a massive problem in HIV+ patients!). Only those with high grade lesions are seen, and the procedure is done with local anesthetic. I won't gross you out with the details, but I did find it really interesting!


I then had an amazing opportunity to watch a lady have an ultrasound at 20 weeks ..... with twins! It was really fascinating, just amazing to see!! Now I know how pretty and cute Little Bird once looked, shame it changed so much with age :P hehe! The Dr was trying to see what sex the babies were, and thought they might both be girls and at that one of them had a wee proving her theory correct! They were really active stretching their arms and legs and moving their mouths. It really was a great thing to see!


In the afternoon, I went to the Inpatients Unit (IPU) or Hospice as it used to be known. It is a few kms down the road, and is set up to care for the patients at the unit to save them from going into the main hospital. It has a male and a female bay, very different to the mixed sex approach now in the UK. It has a small isolation room for 1 patient, perhaps who has TB which may be drug resistance. They do not necessarily barrier nurse but it keeps them separate from the others. There were only 4 patients so it was very quiet. There are currently students at the IPU, and they had a teaching session whilst I was there on TB. They were also told about holistic care - something they didn't have a clue about so I told them! It’s something we learn in the UK from day one, further emphasizing many of the differences I have already found! However, they do seem very knowledgeable and their training is just different to ours.


& then it rained .....lovely reminder of home! Haha

OT, Monkeys, Follow-ups & Bible Group

(Tuesday) Today I spent the morning in with the Occupational Therapist (OT). She only had one patient booked, so I got to spend some time talking to her about the job. It seems very similar to the UK, although like nursing it is a 4 year course!  They have a lot of good equipment, although not to modern as that I've seen in the UK. The patient I got to see was a young girl who had had 2 strokes in 2009 & 2010. She is making remarkable progress. At first she couldn't speak for nearly 2 months, and now she speaks SiSwati & English very well indeed! It was great to see the things the OT did with her, mostly stretching based. Again very similar things I have seen on neuro patients in the UK, mostly getting the muscles in her arm and leg (as her left side was affected both times) to loosen. She also helps her with her memory and school work. It’s very rewarding to see. The biggest problem the OT has is keeping up with patients. Follow ups in a rural area are rare, and patients struggle to get to the clinic regularly. Therefore, simple stretches they can do themselves at home are the best type of therapy for them!


Whilst in with the OT, we saw a monkey on the roofs outside! One of the men was telling me they are a nuisance as they are always around, and like to try and get in the window if you leave them open! He told me not to leave my window open at night or I would wake up to find a monkey snuggled in bed next to me hahahaha!


I spent the afternoon with the Dr, again with follow up patients. Some had TB and needed their follow-up meds. TB is a common problem in HIV+ patients, and is a notifiable disease so patients need to have a green card with their details on. I also saw a man who had turned white! His skin had peeled off a few years ago, and so he had lost all the pigment in his skin. It was very strange to see, and they have no idea how it has happened. They think it may be related to the HIV, or be something like Michael Jackson had! He also had alopecia (hair loss) so had no hair and very little eyebrows! Certainly an image I will never forget.


In the evening I went to a home bible group with the OT. It was actually very interesting, although I felt a little out of place! Christianity is the main religion in SA, and ACTS is a very spiritual and religious place. It was great to see young people my age meeting up to have some discussions about their faiths, and to sing and pray and preach. It is interesting to see how much faith has an influence in these peoples lifes, despite the many diseases and illnesses around them.